How to Become a Certified Nursing Assistant

The role of Certified Nursing Assistant, or CNA, is quickly becoming one of the fastest growing careers in healthcare. This is largely due to the increasing age of the Baby Boomer generation and advancements in medical care which allows for a longer lifespan. According to the US Bureau of Labor Statistics, CNA job growth is expected to be 21% for the 2012-2022 decade. To meet the demand, many schools are offering CNA programs to prepare the student for the federally mandated state exam.

CNA program options range from 100% online courses to 100% classroom courses and can cost anywhere between $400 and $3000. With so many options available, getting started in a career in healthcare has never been easier!

About the CNA Role

The role of the CNA is to support the licensed practical nurse and the registered nurse by providing patients with basic care. They are employed primarily by hospitals, long­term care facilities, acute care facilities, and home health agencies. The pay rate ranges greatly by state and type of facility as well as by shift preference. But in whichever facility the CNA chooses to work the primary job duties remain somewhat consistent.

While the CNA's job duties include a wide range of tasks, primary responsibilities include obtaining vital signs and recognizing and reporting abnormal values, answering call lights, setting up and removing medical equipment, and assisting the patient with activities of daily living (ADL's). As the name implies, activities of daily living include basic activities that an individual engages in to maintain their daily health and wellbeing.

CNA's Role in Assisting the Patient with Activities of Daily Living Include:

Meal preparation and delivery

Assisting the patient in ambulating to the bathroom for the elimination of bowels and/or bladder

Providing or assisting with hygiene, including showers and baths Assisting with ambulation

Assisting the nurse with repositioning the patient in bed and/or range of motion for the immobile patient

Grooming the patient

Maintaining a clean patient environment

CNA's must be compassionate, caring, empathetic, kind, and have patience with others. They are sometimes the only person a patient will see in a day, such as with home health care, and they can bring tremendous joy and happiness to this person through companionship. In some situations, the CNA may know the patient and family better than any other member of the healthcare team, and often their expertise is appreciated when discussing and determining the plan of care.

Considerations When Choosing a CNA Program

Certified Nursing Assistant programs are sweeping the nation. Every state now has at least one CNA program and more are being established every day. From online programs with on­site clinical requirements to 100% classroom models, potential CNA students have many options for obtaining CNA education. When considering a program, be sure it complies with state and federal requirements.

The 1987 Nursing Home Reform Act requires the CNA student to have at least 75 hours of training, 16 of which are required to be clinical hours, or "hands­on" training. A quality program should provide at least these minimum requirements, however the actual hours a program requires to graduate may vary greatly from school­to­school. When considering a CNA program, it's best to choose one that fits the schedule of you and your family.

Some Issues to Consider When Selecting a CNA Program Include:

Do you have a preference for day or evening classes?

If you plan on working your current job during the CNA program be sure you will have time to study, maintain family life, and, don’t forget, sleep! With so many programs available, a suitable program for your lifestyle is likely available.

Are you an effective online learner?

Some students are excellent at online learning. Characteristics for a great online learner include being a self ­starter, highly motivated to learn and complete the program, good reading comprehension skills, and time to complete each class. Find out exactly how many hours of studying the school recommends for each online class and be sure you are able to comply. This may not always be accurate but it’s a great place to start.

Is childcare an issue?

Finding quality daycare during school hours is necessary for many parents. If unable to find affordable daycare, perhaps online programs or evening classes are a better fit than daytime classroom. Don’t forget the federally required 16 clinical hours and ask the school at what point during the program and where these hours are fulfilled. Some schools may even offer daycare.

How fast do you wish to complete your CNA education and start working?

Certain schools may offer a fast ­track program to expedite CNA education. These courses are usually offered as long days for a short while instead of shorter days for a long period of time.

Fast­track programs are sometimes more expensive than traditional or online program because of their convenience.

How much money can you afford to spend?

Be sure the program matches your budget and pay schedule. Some schools allow a pay ­over­time option and may even offer financial aid. Fast­ track programs and online programs may be more expensive because they are more convenient than traditional programs. So be sure to weigh all options before committing to a program.

General program requirements vary by program but usually require the student to be at least 16 years of age, hold a state driver’s license or social security card, be able to pass a physical exam, background check and drug screen, have proof of vaccinations including a tuberculosis test, and have completed basic English and math courses. Being fluent in English is required by most schools, as well.

To qualify for graduation, the CNA student must demonstrate knowledge of basic patient care while performing tasks while under the direct supervision of a licensed nurse and pass the state exam. Good attendance in the classroom and at clinicals as well as passing scores on tests are program requirements.

Choosing a Quality CNA Program

Choosing any school for healthcare positions takes special consideration to choosing a career not in healthcare. Similar to choosing an LPN program, choosing a CNA program must be carefully researched.

State Exam Pass Rates: Each state posts a list of CNA schools along with their state exam pass rates. Choosing a school with at least a 75% pass rate is ideal. Pass rates demonstrate the effectiveness of the program in teaching its students. If pass rates are low, the school may not provide qualified instructors or educational materials to facilitate learning.

Social Media: Websites such as AllNurses, Facebook, Twitter, and LinkedIn may provide some feedback to you from students at the school.

Required Hours: The state mandates at least 75 hours of classroom, or didactic, instruction and 16 hours of clinical experience. A legitimate program must provide these requirements to allow the student to qualify to take the state board exams.

Cost: The cost of a CNA program can vary greatly from state­ to ­state, by type of program, and by school. CNA programs can cost anywhere from $400 up to $3000. Reasons for the variation include offering more clinical or classroom hours than the federal requirement, convenience of online courses, and reputation of the school. Some programs may require college courses in English or math and if you have already completed these courses the program cost may be less than advertised. Also, some schools may include the cost of textbooks and other education material with the tuition fees while others charge extra once enrolled.

Preparing for the State CNA Exam

Attending a quality CNA program should prepare its students for the state exam. In addition to classroom materials the student may benefit from online sources. Searching the internet for “CNA state exam practice questions” will provide some additional resources. Flashcards, practice exams, and study topics are available both free and for a nominal fee.

Working as a CNA

After successfully passing the state board exam the newly certified nursing assistant can now apply for positions. While the acute care hospital positions are often highly sought after this role may not be a good fit for every CNA.

CNA’s working in a hospital environment primarily obtain vital signs and sometimes point ­of ­care blood sugar test using a glucometer, answer call lights when patients need assistance, help patients get to the bathroom, help patients walk around the hallways, assist the patient in eating meals, and assist the nurse with dressing changes or treatments. Patients in the hospital usually do not stay for extended periods of time, so the relationship a CNA forms with the patient is often short­ lived.

CNA’s working in acute care or long ­term care facilities focus mainly on distributing and assisting with meal consumption, showers, helping patients with getting to the bathroom as well as checking to be sure incontinent patients are clean, and helping patients get ready for the day in the morning. This may include performing oral care and dressing the patient then helping them get into their wheelchair for the day. Vital signs and blood sugars are not usually checked as often in this setting as in the hospitals environment.CNA’s in this setting may feel a great sense of joy and pride as they bond with their patients and are able to provide them with dignity and friendship over a long period of time. Patients in these settings usually remain there for extended periods of time.

CNA vs LPN

When deciding a career path in nursing, CNA, LPN and RN are the options to consider to get started. Master’s level education can be achieved , if desired, but usually a nurse practitioner works as a CNA, LPN, or RN first.

Similar to considering the LPN vs RN path, the CNA vs LPN career should also be compared:

CNA’s work under the direction of a licensed nurse, either RN or LPN, depending on the healthcare setting

CNA’s are not licensed, they are certified

CNA’s attend less hours of school than the LPN to become certified and start working faster

CNA’s earn less money than LPN’s in the same setting

The CNA role focuses on completing tasks and activities of daily living and LPN’s consider overall goals and plan of care

CNA’s do not usually hold supervisory positions

Many CNA’s use this role as a platform to gain experience in the healthcare field and discover what the LPN and RN role consists of. While the CNA position is entry ­level, it is a vital role in the healthcare field. CNA’s provide a personal level of care which LPN’s and RN’s may not be able to provide. RN’s and LPN’s often look to the expertise of the CNA for certain aspects of patient care.

Many CNA’s later return to school and complete licensed practical nursing (LPN) or registered nursing (RN) education while working as a CNA. In many states, CNA to LPN bridge programs are offered, as well as LPN to RN bridge programs. These programs credit the student with courses already completed so they may be less expensive than the full traditional course.

Wait lists for a CNA bridge program are usually shorter than for a non ­CNA. RN wait lists can be as long as 5 years in some places, so it makes sense to work as a CNA while attending LPN school then work as an LPN while attending RN school. And in the meantime, instead of working in a job unrelated to healthcare, the student is gaining a lot of healthcare experience while attending school.

Finding a CNA Job after Graduation

Once a student graduates from CNA school and successfully passes the state CNA exam they will want to find a job, and fast! But where should the search begin? Most facilities post job openings online along with job requirements and sometimes hourly pay rates. Completing the online application and sending an updated resume and cover letter will hopefully illicit a response. Helpful resume and interview tips can be found online or from experts willing to create your resume for maximum effectiveness.

CNA’s have a crucial role in the healthcare team and a career as a CNA can be very rewarding. With job growth expected to increase through the next decade and schools offering flexible programs to meet a variety of schedules and budgets the time has never been better to become a CNA.

CNA Salary

State

CNA Median Salary

Alabama

21,180

Alaska

35,120

Arizona

27,440

Arkansas

21,030

California

28,210

Colorado

27,560

Connecticut

31,030

Delaware

27,570

District of Columbia

28,520

Florida

23,140

Georgia

21,280

Guam

23,580

Hawaii

29,810

Idaho

22,230

Illinois

23,840

Indiana

22,720

Iowa

23,810

Kansas

22,540

Kentucky

22,790

Louisiana

19,910

Maine

23,810

Maryland

27,620

Massachusetts

29,070

Michigan

26,380

Minnesota

26,830

Mississippi

20,250

Missouri

22,140

Montana

23,940

Nebraska

23,830

Nevada

30,850

New Hampshire

28,050

New Jersey

27,410

New Mexico

24,550

New York

32,700

North Carolina

22,340

North Dakota

27,680

Ohio

23,740

Oklahoma

21,490

Oregon

27,100

Pennsylvania

27,330

Puerto Rico

18,610

Rhode Island

28,030

South Carolina

21,650

South Dakota

22,680

Tennessee

22,520

Texas

22,980

Utah

22,580

Vermont

26,570

Virgin Islands

24,760

Virginia

23,380

Washington

27,920

West Virginia

21,810

Wisconsin

25,770

Wyoming

27,310

Source: U.S. Bureau of Labor Statistics, May 2012

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